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Registered 08:00 AM 09-07-2011
Need some help here. I'm a reg just trying to keep things discreet.

I have a child that arrived here today and DCM says she had a small rash and she might take her to the Dr tomorrow to get her checked out. She showed me her neck and it looked like an allergic type rash just a little red but flat. I said ok thanks for showing me. DCM leaves and I get the kids breakfast.

Upon washing hands I notice a blister on the back of DCG hand, another on her finger, another... checking another... Total of 6 blisters on her hands, small bumps that look like blisters anyway. The center was like a translucent looked to be filled with clear fluid. They were raised and look like they may burst but were not red. I checked her armpits and chest. She had a few old ones that busted I guess but her legs looked as if they were eaten up! Scabby with old bumps. I called DCM and told her she would have to pick her up and have her checked being the bumps/blisters were on her hands they could burst and infect other kids or the toys. This child also had MRSA infections before she came to me. I don't know what that looks like but know it's serious so I am worried. DCM looked at them and said she doesn't know but since she has problems with MRSA she will call and get her checked. I'm very worried now! I told DCM that she would have to have a Drs note stating the diagnosis and that it is not contagious to other children in daycare.

Parents have gotten mad when I send home for rashes but they scare me! I have only sent home twice before. Last time the child was bitten by bedbugs or spiders they weren't sure.

What is your policy on rashes and bumps? This DCM didn't put up a fight but others have. Is there a state policy we can use to back us up?
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familyschoolcare 08:46 AM 09-07-2011
If the cause is unknown then a doc. note is needed. A few weeks a go one of my dck had three bumps on his face since they looked like bug bites. Talked to dcm about them at pick up.
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Crystal 10:01 AM 09-07-2011
sounds like hand/foot/mouth a.k.a. coxackie virus.

too late. everyone has been exposed. they were exposed before the rash even appeared, as is the case with most any rash.

there is nothing the dr. can or will do to treat it. it is a virus that has to run it's course. it can be quite painful, so motrin or tylenol will probably be in order. also, lots of fluids and things that are easy to eat, as blisters appear in the mouth as well.

clean, clean, clean. bleach tables/chairs/light switches/doorknobs/toys.

I don't exclude for rashes, I just inform the parents that their child has been exposed.
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Registered 10:31 AM 09-07-2011
Originally Posted by Crystal:
sounds like hand/foot/mouth a.k.a. coxackie virus.

too late. everyone has been exposed. they were exposed before the rash even appeared, as is the case with most any rash.

there is nothing the dr. can or will do to treat it. it is a virus that has to run it's course. it can be quite painful, so motrin or tylenol will probably be in order. also, lots of fluids and things that are easy to eat, as blisters appear in the mouth as well.

clean, clean, clean. bleach tables/chairs/light switches/doorknobs/toys.

I don't exclude for rashes, I just inform the parents that their child has been exposed.
She hasn't been in daycare since Friday. DCM had 4 days off. Is it possible there wasn't any exposure or at least minimal? No toys had been played with yet we had just started breakfast. She hasn't been around the other children since Friday is it possible they are safe. She had no symptoms of anything on Friday. How long until she is no longer contagious if that is the case? I can't allow others catch this if it is possible to avoid.
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Sunshine44 02:48 PM 09-07-2011
I agree with Hand, mouth and foot. Been there, done that. It's the right time of year for it too. There is nothing you can do if that is what it truly is. All kids will have it within a week I'd bet.
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Crystal 02:52 PM 09-07-2011
Originally Posted by Registered:
She hasn't been in daycare since Friday. DCM had 4 days off. Is it possible there wasn't any exposure or at least minimal? No toys had been played with yet we had just started breakfast. She hasn't been around the other children since Friday is it possible they are safe. She had no symptoms of anything on Friday. How long until she is no longer contagious if that is the case? I can't allow others catch this if it is possible to avoid.

Here is a fact sheet:



http://ucsfchildcarehealth.org/pdfs/...Mouth_0509.pdf
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nannyde 03:00 PM 09-07-2011
http://www.mayoclinic.com/health/han...ION=prevention

Isolate contagious people. Because hand-foot-and-mouth disease is highly contagious, people with the illness should limit their exposure to others while they have active signs and symptoms. Keep children with hand-foot-and-mouth disease out of child care or school until fever is gone and mouth sores have healed. If you have the illness, stay home from work.

Hand-foot-and-mouth disease is usually a minor illness causing only a few days of fever and relatively mild signs and symptoms. However, a rare and sometimes serious form of the coxsackievirus can involve the brain and cause other complications:

Viral meningitis. This is an infection and inflammation of the membranes (meninges) and cerebrospinal fluid surrounding the brain and spinal cord. Viral meningitis is usually mild and often clears on its own.Encephalitis. This severe and potentially life-threatening disease involves brain inflammation caused by a virus. Encephalitis is rare.

Children usually develop immunity to hand-foot-and-mouth disease as they get older by building antibodies after exposure to the virus that causes the disease. However, it's possible for adolescents and adults to get the disease.
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Kaddidle Care 06:54 PM 09-07-2011
Look up Scabies and see if the rash looks like that. I may be totally off base but that part about previous "bites" put me on alert. I'm glad you sent her home and to the Dr.
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Registered 07:29 PM 09-07-2011
It doesn't look like scabies or MRSA (thank God) but some pictures of the Hand foot disease look like it so really nervous now. To top it off DCM didn't take her to the doctor today. I called her at 7:00pm and asked what the doc said since I haven't heard from her all day. She says, "sorry forgot to call you this morn. I'm not taking her until tomorrow sometime." I reminded her of the policy to bring a Dr note stating the diagnosis and if she is contagious to the other little ones before DCG can return. She said sat there for a minute then grumbled saying she knows. She didn't have much to say so maybe she is upset or DCD is upset. I don't think she is upset over work because she actually giggled when leaving saying at least it got her out of work. Maybe she is just using this for an excuse to take tomorrow off too, who knows. I have had many problems with these parents following guidlines. This isn't the 1st health issue with DCG either. I would have my child checked ASAP! DCM often uses the excuse that the Doctor is "on vacation or something because she isn't in". I tell ya this Doctor has had MANY vacations this year she must be rich! I more so hate the fact that she thinks I am stupid! ALL doctors have a back up!! If one wouldn't I would switch doctors!

So now I think either she just doesn't care and thinks she can just bring her back OR she has been confirmed with something contagious and doesn't want to tell me. She knew this poor little girls ankles/lower legs were eaten up and she still brought her and only pointed out the small flat red rash on her neck.
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Registered 08:34 AM 09-08-2011
Update!

DCD just called me and said DCG has been checked and the Dr. diagnosed her with either Chicken Pox, Measels or Scabies! They aren't sure yet. He advised me to wipe down all the toys and materials.

I am in shock! Why would the Dr say this and then send them home? I asked that and DCD said they are still trying to figure out what it is. The call came in from the home not the cell and I hear the kids in the background so I assume they are home. This just doesn't make sense!

I told DCD I need to know exactly what it is so that I can inform my other clients of the possible exposure. He just said he understands and will get back to me.

What now? I have never encountered scabies! How bad is it? What do I tell my clients in the meantime? Are the other kids safe since the DCG hasn't been around them since Friday?
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registered 01:22 AM 09-09-2011
I am sorry to be a nag but is there anyone who can help with this matter?

I am at a loss here and trying to keep things discreet here as well as within my daycare but issues are getting worse!

I called DCM back this afternoon and asked if DCG had an actual diagnosis yet. She says "well yes they said that it was scabies but Bob described this to his friends and they say it's pox not scabies so we are taking her out to the ER for a second opinion" OMG! OK so it is scabies! I asked if she got the required note from the Doc and she said no because she doesn't think it's scabies. WTH????

I explained to her that I MUST inform the other parents of the actual disease the children have been exposed to and I can't very well relay what she just said! She says she understands and will tell me more when she knows more that they will be taking DCG to the ER soon. I told her I need a phone call ASAP with a definate diagnosis for her file and the other parents and my own family. I told her to PLEASE please text even if it's 3 am! She promised and here I sit at 3am, no call or text, can't sleep and itching with worry! I text her at 9:00pm and it went ignored. What do I do now?

What in the heck is wrong with her? I had no choice so just informed the parents it is either pox or scabies we don't know yet. (I cant give them details about DCMs convo yet I don't have a Dr slip to go on either) I don't know what else to say and they know who I am talking about since she was the only parent not here! I have a concerned parent that said she has to know immediatley if it's scabies because if it is, even just being exposed her Dr says the children should be checked and put on a cream just in case.

I have never had exposure to this. I have never known anyone to have this. I jsut don't know what to do here. DCM is really not cooperating with me on this. I don't want these poor kids to have to get checked and get this cream spread it all over them if it is pox but according to DCM the Dr said scabies. According to DCD the dr said scabies or Pox. DCM is a little slow, lord forgive me but it's true, so what do I believe? Where do I go from here?
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Kaddidle Care 05:12 AM 09-09-2011
OK so I was not off base suspecting this. Start by reading here:
http://www.mayoclinic.com/health/scabies/DS00451

Insist on a Dr's. note with a definite diagnosis. He/She should have taken a scraping to determine whether it is scabies. It is a mite - in dogs it's called mange.

Treat this like you would treat head lice - clean everything and I would steam clean the carpeting.

I'm so sorry you are going through this.

Hopefully Nannyde will have more advice since she's a Nurse.
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3kidzmama 05:19 AM 09-09-2011
I actually am dealing with exactly the same problem right now, except my culprit is my assistant. She came to work on Tuesday and then called sick on Wednesday to go to the dr. Turns out she has scabies. Which means all of my kiddos and myself and family have been exposed. I have cleaned everything in sight and am checking the kids everyday for signs, so far we haven't seen any indication that anyone else has it.
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nannyde 05:51 AM 09-09-2011
Originally Posted by 3kidzmama:
I actually am dealing with exactly the same problem right now, except my culprit is my assistant. She came to work on Tuesday and then called sick on Wednesday to go to the dr. Turns out she has scabies. Which means all of my kiddos and myself and family have been exposed. I have cleaned everything in sight and am checking the kids everyday for signs, so far we haven't seen any indication that anyone else has it.


So sorry to hear that. I forgot to add scabies to the critter list in my Staff Assistant part five blog.

https://www.daycare.com/nannyde/the-...ant-part-5.htm

Little pests that can cost you a bundle:
Itís a good idea to discuss fleas, scabies, head lice, and bed bugs (eeek) with your employee during the interview process. If the employee brings in critters to your home it can cost many hundreds of dollars and a ton of work to rid yourself and your environment of the bugs. You can also loose families because of repeated exposure.

I talk to my employee and let them know that Iím willing to pay for flea control and head lice products if they or their home is exposed. I donít want them to be embarrassed to tell me about any exposure because it is much cheaper for me to help them deal with it BEFORE they bring it into my house than after.
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familyschoolcare 09:33 AM 09-09-2011
OP can you call the child's doctor your self and have him/her send you something in writing. I do not know where you are but here in Cal. I have the name and number of each child doc. must have it on file.
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familyschoolcare 09:34 AM 09-09-2011
One time when i was teaching PE a doc. note came to me that appeared to be added to after the child left the office call the doc my self to get the "dirt" long story short the part of the note was a fake.
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Kaddidle Care 02:10 PM 09-09-2011
With the privacy laws these days the only way she could get any information from the Dr. is by having the parent sign some sort of a permission document.
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Crystal 02:14 PM 09-09-2011
Odd that scabies would have blisters. I think I need to go research that a bit, I never knew that scabies could blister. It's more of a "roving" type rash, as the rash occurs in reaction to the body lice biting under the skin...when the louse moves, the rash should fade and then will reappear in another location.
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safechner 03:45 PM 09-09-2011
I can't believe dcm is not cooperated with you but I would call her doctor myself to find out what is going on with your dcg. You would need to get this information for your daycare parents. After that, I will terminate them immediately! There is no excuse for this!
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Kaddidle Care 10:19 AM 09-10-2011
Any update on this?
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registered 07:22 PM 09-10-2011
Originally Posted by Kaddidle Care:
Any update on this?
Yes with some help from a couple great ladies here!

I started freaking because a local center gave me advise that the kids would be out for weeks (costing me literally hundreds) AND I had to bleach everything in sight even if they didn't touch it... lots of scary details. After talking to someone here who knows what shes doing I found out they can return as soon as they are treated. That made me feel better! Until DCM tells me she will be taking more time off anyway!

DCM & DCD had me a wreck because they wouldnt treat DCG or get the 2nd opinion they wanted. They just sat on this for 4 days!! They were going on the friends opinion it is just pox. I got stern with them and told them this is my family we are talking about as well as the others! DCM called back Friday evening and said they will just accept the Drs diagnosis of scabies even though thats not what it is. OK great did you treat her? No but we will and they gave us prescriptions too. OK did you get them filled, not yet...

My child and I got the cream and used it. Cost $90 for 1 tube!!! I am mad at this family for bringing it in in the 1st place! DCM knew DCGs legs were covered with old sores and I bet she knew about the new ones on her hands too. What's worse is I called DCD to tell him payment was due on Monday for the prior weeks care. He said he will get it to me when he can he doesn't have it. Yet I have to come up with $90 to cure a disease you brought to me? Nice!

DCM calls today to tell me she didnt get a Dr slip but the Dr told her she can return on Monday. I told her she can NOT return with out it for the 100th time! I told her take Monday get to the Dr get the slip and come on Tuesday. She said that's fine but on 2nd thought she is having the Dr write down to not allow DCG back for a week or so just to make sure she is healing. Something is fishy! I know DCM hates to work and will use any excuse to get out of it but I don't think that is the only reason here because she can keep DCG home on her own.. The Dr slip doesnt have to state that! I asked if she used the cream on DCG she hesitated then said yes. I said ok did you and the family use it too? She said well we got it. I said ok but did u ALL use it u have to use it together so as not to reinfect DCG. She then said yeah we did. Fishy!!!

I spent days cleaning my home and all the bedding etc. Using the meds. If she brings it back I will term them! I can't risk these illnesses they keep bringing in. DCG had MRSA, DCB just gave us all colds, they have had other health matters and now this and if she isnt treated properly she will bring it again! All within 6 months! AND I know DCM wont clean her house! Anyone know if terming due to illness is allowed? I am worried about Hepititus or something else next!

Sorry rambled but now you have the rest of the story. Thanks for asking!
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Kaddidle Care 02:55 PM 09-13-2011
Sorry I missed your post - just saw it now.

There is no way I would let those children back into my Daycare without a Dr's. note stating they've been rechecked and are clear to attend. (I would also check up on that Dr. to make sure he/she is legit and verify the note.)

As far as them not believing the Dr. - if the Dr. took a scraping and looked at it under a microscope and DX'd as Scabies, then it's scabies. I wouldn't trust them to treat the child. If this is the only child in the family that has it, I would imagine her immune system is compromised and yes, there may be something else health wise going on there.

I sure hope they take this seriously. The hesitation in their responses tell me they may be lying to you. It also sounds like they are stalling and seeking other care while they continue to hold a place with you. Do not allow them to come back without paying you upfront.

You may want to think very hard about filling the spots.
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sharlan 03:01 PM 09-13-2011
I would seriously consider terming this family.

Chances are they did not fill the prescription, therefore, they didn't use it.
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Tags:allergic, blister, bumps, contagious, foot and mouth!, meningitis, rash - chest
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